Shokri Tom, Sokoya Mofiyinfolu, Cohn Jason E, Bahrami Arash, Inman Jared, Ducic Yadranko
Resident, Department of Otolaryngology - Head and Neck Surgery, Penn State Health Milton S. Hershey Medical Center, Hershey, PA.
Assistant Professor, Department of Otolaryngology - Head and Neck Surgery, University of Arizona School of Medicine, Tucson, AZ.
J Oral Maxillofac Surg. 2020 May;78(5):778-781. doi: 10.1016/j.joms.2019.12.030. Epub 2020 Jan 7.
Zygomaticomaxillary complex (ZMC) fractures occur often. However, no clinical consensus has been reached regarding the number of fixation points required when performing open reduction and internal fixation (ORIF). The objective of the present study was to explore the utility of single-point fixation in the management of noncomminuted ZMC fractures.
We analyzed the data from a retrospective case series of 211 patients treated during a 20-year period.
The mean length of follow-up was 3.4 months. Of the 211 patients, 162 with noncomminuted ZMC fractures had been treated with single-point fixation of the zygomaticomaxillary buttress. During the follow-up period, 1 patient experienced tooth loss because of a root present in the fracture line, 7 experienced intraoral plate exposure, with 2 subsequently undergoing plate exchange, and 8 developed a wound infection. No patients required orthognathic surgery or cheek implants for malar asymmetry. No patient developed hypoglobus or enophthalmos, and none required revision ORIF of their ZMC fracture.
To the best of our knowledge, the present study represents the largest series in the literature reporting the surgical results and outcomes of patients with noncomminuted ZMC fractures treated with single-point fixation. In experienced hands, we believe this is a viable surgical option if appropriate surgical considerations are made.
颧上颌复合体（ZMC）骨折较为常见。然而，在进行切开复位内固定（ORIF）时所需固定点的数量尚未达成临床共识。本研究的目的是探讨单点固定在非粉碎性ZMC骨折治疗中的效用。
我们分析了20年间211例患者的回顾性病例系列数据。
平均随访时间为3.4个月。在211例患者中，162例非粉碎性ZMC骨折患者接受了颧上颌支柱单点固定治疗。在随访期间，1例患者因骨折线处有牙根而出现牙齿脱落，7例出现口内钢板外露，其中2例随后进行了钢板更换，8例发生伤口感染。没有患者因颧骨不对称需要正颌手术或植入脸颊假体。没有患者出现眼球下斜或眼球内陷，也没有患者需要对其ZMC骨折进行翻修ORIF。
据我们所知，本研究是文献中报道非粉碎性ZMC骨折患者接受单点固定手术结果和预后的最大系列研究。我们认为，如果进行适当的手术考量，在经验丰富的医生手中，这是一种可行的手术选择。
